Dentigerous Cyst: a Case Report

Abstract

Introduction : A cyst can be defined as a pathological cavity which contains fluid or semisolid material and is lined by an epithelium sac. Dentigerous cysts are odontogenic lesions, the second most common type after the radicular cysts. They are formed from residual remnants of the enamel epithelium and are histologically benign. The aim of the following report is to present a case of a dentigerous cyst with a rapid development and increasing size but asymptomatic course. Materials and Methods : A 30-year-old male was referred to the Department of Oral Surgery at the University Medico-Dental Centre because of a diagnosed cystic lesion with a significant size, encompassing the crown of the impacted mandibular third molar (tooth 48). It was found that the lesion was asymptomatic with the only complaint being dull, transitory pain in tooth 47 which was endodontically treated 2 years ago. An analysis of the panoramic radiograph was performed, a CBCT examination was done to determine the exact size, borders of the cystic lesion and its relationship to the mandibular canal and the second molar. After precise diagnostics the chosen method of treatment was radical extirpation of the cyst combined with odontectomy of the impacted molar and extraction of tooth 47. Results : On the panoramic radiograph and the CBCT image a unilocular radiolucency was present, with a well-circumscribed border and visible osteosclerotic margin, enclosing the crown of tooth 48 and the distal root of tooth 47 to the interradicular plate. No asymmetry, crepitation or exudation were present in the affected area. The operation was performed under general anaesthesia. No further complications occurred. Conclusion : Dentigerous cysts frequently show no clinical symptoms. This undoubtedly leads to difficulties in the diagnostics. Therefore, thorough examination shall be performed because early diagnosis reduces the risk of complications during the treatment.